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Home My WebLink AboutBUSINESS PLAN Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This ~ermit is Issued for the following: I~ H,~-~dous Materials Plan [] Unde~round Storage of H~rdous Mat~als Permit ID ~:: 015-000-001103 ~ RiskManagem~tP~ram RUBEN BARTELL FARMS D Ha~ous Waste On-Site T~t~t LOCATION: 1500 COFFEE RD ~'~ ~ ~ .... :~- ~ ~.~. OFFICE OF ENWR ONMENTAL SER VICES ~~~ 1715 Chester Ave., 3rd Floor Apprgwdby: ' C u~ ~. ~; ~s~t~ Bakersfield, CA 93301 o~ore~~s~i~ ~ Voice (661) 326-3979 --~- F~ (661) 326-0576 Exp~tionDate: June 30, 2003 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE .....,::,~,,,,¢???.;E?;i:;~?~?!?.i!~;,,~==,,,;,, ........ This permit is issued for the following: ..... ~¢¢?i?'¢'~/Z~:i~:i;~:Zi~;i~:,2:,?,;?.?.El!iHazardous Materials Plan PERMIT ID~ 015~21~01103 .:~,¢?~, ~ ~:~.:?~:;~?~}}?' ~:~:~.~;~;~?~;~F?~}~}~~agement Program RUBEN BARTELL FARMS LOCATION 1500 COFFEE ~.,-.. ~ ~ ..: ':.::::..::..,.//~, ...., ~?..~., .,.,; · ,, , ,... ~ %~ · ~ ~. ..... [~=~-. -..'~h. .*',*. ~.~ .... %::::: ' ~ ~,~ ~:i.. '"' ' ...... .~,.~? [ss~ by: 0 Bakersfield Fire Dcpa~mcnt Approv~ by: ~~~' OFFICE OF EN~ O~3L S~ ~CES 1715 Chewer Ave., 3rd Floor B~e~fiel~ CA 93301 Voice (805) 326-3979 F~ (80S)~2~57~ Expiration Date: ~n~ ~0~ ~0OO FORI~ ~ ONE) SITE DI~GR,a~ ~// ~CI~IT¥ DIAGRAM Inspector's Comments): -OFFICIAL USE ONLY- HI~CU-13 RUBEN BARTELL FARMS SiteID: 015-021-001103 Manager : ~ BusPhone: (661) 589-3369 Location: 1500 COFFEE RD~/ Map : 102 CommHaz : Low City : BAKERSFIELD Grid: 28A FacUnits: 1 AOV: CommCode: COUNTY STATION 65 SIC Code:0131 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title CURTIS BARTELL / SON RUBEN BARTELL / Business Phone: (661) 589-3369x Business Phone: (661) 589-9259x 24-Hour Phone : (661) 589-3369x 24-Hour Phone : (661) 589-9259x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth 'Contact : Phone: (661) 589-3369x MailAddr: 1500 COFFEE RD State: CA City : BAKERSFIELD Zip : 93308 Owner RUBEN BARTELL Phone: (661) 589-3369x Address : 1500 COFFEE RD State: CA City : BAKERSFIELD Zip : 93308 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd:. RSs: No ParcelNo: Emergency Directives: ~~ reviewed ~he ~ached hazardous materials manage- ment p~n ~or ~/,~_~ g~,,-7~'~/1/~/'~nd t~ j~ ~ng ~h any ~rre~ions ~ns~i~s a comp~o~ a~d ~rr~ man- ~emem plan for my facility. -1- 10/17/2003 RUBEN BARTELL FARMS SiteID: 015-021-001103 ~ Hazmat Inventory By Facility Unit -- MCP+DailyMax Order Fixed Containers on Site Hazmat Common Name... ISpooHazlEPA HazardsI Frm I DailyMax IUnit.IMCP PROPANE E F P IH G 500.00 GAL Hi ACETYLENE E F P IH G 330.00 FT3 Hi DIESEL ~2 F IH DH L 1000.00 GAL Low OXYGEN F IH DH G 230.00 FT3 Low MOTOR OIL F DH L 330.00 GAL Min 2 10/17/2003 -3- 10/17/2003 RUBEN BARTELL FARMS SiteID: 015-021-001103 ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: CENTER OF LOT CAS# 74-98-6 F STATE i TYPE PRESSURE i TEMPERATUREI CONTAINER TYPE Pure Above Ambient Ambient . . Gas PORT PRESS CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average 500.00 GALI 500.00 GALI 500.00 GAL HAZARDOUS COMPONENTS 100.00 Propane Yes 74986 HAZARD ASSESSMENTS TSecretl ~SIBi°HaZNo N No Radi°active/Am°unt I EPA HazardsNo/ Curies F P IH NFPA/// USDOT# I MCPHi = Inventory Item 0005 Facility Unit: Fixed Containers on Site 9 ~LVLLVL~£~I £~lZ-~LVJ. r'. / ~L--LJ~LVL/~Z%.~, ACETYLENE Days On Site 365 Location within this Facility Unit Map: Grid: N END OF SHOP CAS# 74-86-2 Gas /Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average 330.00 FT3I 330.00 FT3I 330.00 FT3 HAZARDOUS COMPONENTS %Wt. RI RSl CAS# 100.00 Acetylene~Yes~ 74862 HAZARD ASSESSMENTS TSecret [No NoRS I Bi°HaZNo Radioactive/AmountNo/ Curies FEPAp HazardsIIH NFPA/// USDOT# HiMCP 4 10/17/2003 RUBEN BARTELL FARMS SiteID: 015-021-001103 ~ Inventory Item 0006 Facility Unit: Fixed Containers on Site DIESEL #2 Days On Site 365 Location within this Facility Unit Map: Grid: MIDDLE SIDE, SE, BY SHOP CAS# 68476-34 -6 STATE --7-- TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid /Pure I Ambient I Ambient I ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 1000.00 GAL 1000.00 GAL 500.00 GAL HAZARDOUS.COMPONENTS 100.00 Diesel Fuel No. 2 N 68476302 HAZARD ASSESSMENTS TSecretI ~SIBioHazI Radioactive/Amount I EPA HazardsI NFPA USDOT# MOP No N No No/ Curies F IH DH / / / Low ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ ::" ~U~U~ ~vl~ / ~£~ ~vl~ OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: N END OF SHOP CAS# 7782-44-7 Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 230.00 FT3I 230.00 FT3 230.00 FT3 %Wt. S CAS# 100.00 Oxygen, Compressed N 7782447 HAZARD ASSESSMENTS TSecret' RS'Bi°Hazl Radi°active/Am°untl I EPA Hazards NFPA I USDOT# MCP No INo I No No/ Curies F IH DH / / / Low -5- 10/17/2003 RUBEN BARTELL FARMS SiteID: 015-021-001103 = Inventory Item 0003 Facility Unit: Fixed Containers on Site MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: E OF SHOP 25FT CAS# 8020835 F STATE i TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Liquid Pure Ambient Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 330.00 GALI 330.00 GAL 330.00 GAL HAZARDOUS COMPONENTS %Wt. CAS# 100.00 Motor Oil, Petroleum Based 8020835 TSecret RS BioHazl HAZARD ASSESSMENTS I Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min 6 10/17/2003 F RUBEN BARTELL FARMS SiteID: 015-021-001103 Fast Format --Notif./Evacuation/Medical Overall Site --Agency Notification 08/18/2000 CALL 911, PHONES INSIDE SHOP & HOMES. -- Employee Notif./Evacuation 08/18/2000 VERBALLY NOTIFY THEM, HOWEVER, ITS JUST ME AND MY DAD. -- Public Notif./Evacuation 08/18/2000 VERBALLY. Emergency Medical Plan 08/18/2000 NEAREST HOSPITAL, MERCY HOSPITAL OR KMC AND FIRST AID KIT INSIDE SHOP. -7- 10/17/2003 RUBEN BARTELL FARMS SiteID: 015-021-001103 Fast Format -- Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 01/06/1993 ENCLOSED METAL SHED WITH DOOR. · ,-----Release Containment 08/18/2000 NEW PLUMBING REPLACEMENT IF NEEDED. SHOVELS WITH DIRT. TRACTORS WITH -- Clean Up 01/06/1993 LANDFILL AT BUTTONWILLOW. -------Other Resource Activation -8- 10/17/2003 RUBEN BARTELL FARMS SiteID: 015-021-001103 Fast Format ~ Site Emergency Factors Overall Site -- Special Hazards 08/18/2000 SEASONAL USE OF PESTICIDES, OCCASIONALLY STORED IN SMALL METAL SIDED SHED E OF SHOP BLDG. --Utility Shut-Offs 08/18/2000 A) GAS - S OF HOUSE B) ELECTRICAL - N OF HOUSE C) WATER - S OF HOUSE AND BACKYARD OUTSIDE (DOMESTIC WELL) D) SPECIAL - NONE E) LOCK BOX - NO Fire protec./Avail. Water 08/18/2000 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS, 300 GAL PRESSURE WATER SOURCE. FIRE HYDRANT - 1 1/2 W/100 PSI WATER FAUCETS, E SIDE OF COFFEE RD. Building Occupancy Level -9- 10/17/2003 RUBEN BARTELL FARMS SiteID: 015-021-001103 Fast Format ~ Training Overall Site -- Employee Training 08/18/2000 THERE IS ONLY MY DAD AND MYSELF AT THIS LOCATION. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: GO TO SAFETY MEETINGS AT KERN COUNTY FARM BUREAU SEMINARS. SET UP BOX FOR MSDS SHEETS AT THE E DOOR OF SHOP. READ MSDS INFO WHEN IT COMES IN. -- Page 2 --Held for Future Use Held for Future Use -10- 10/17/2003 RUBEN BARTELL FARMS [~:?15~'~"'~"~,~'T'?z~,~,- i SiteID: 015-021-001103 Manager : ' ~ ~U~I~ ~8 BusPhone: (805) 589-3369 Location: 1500 COFFEE RD~,,~,J~--~?~_:~ Map : 102 Com~az : Low City : BAKERSFIELD /~ _ Grid: 28A FacUnits: 1 AOV: CommCode: CO~TY STATION 65 SIC Code:0131 EPA Nu~: DunnBrad: Emergency Contact / Title Emergency Contact /~itle CURTIS BARTELL / O--O~ RUBEN BARTELL / Business Phone: (805) 589-3369x Business Phone: (805) 589-9259x 24-Hour Phone : (805) 589-3369x 24-Hour Phone : (805) 589-9259x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : Phone: ( ) - x MailAddr: 1500 COFFEE RD State: CA City : BAKERSFIELD Zip : 93308 Owner RUBEN BARTELL Phone: (805) 589-3369x Address : 1500 COFFEE, RD State: CA City : BAKERSFIELD Zip : 93308 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ~ Hazmat Inventory One Unified List ~ As Designated Order Ail Materials at Site Hazmat Common Name... IspecHaz EPA HazardsI Frm DailyMax IUnitlMCP PROPANE F P IH G 500.00 GAL Hi MOTOR OIL F DH L 330.00 GAL Min OXYGEN F IH DH G 230.00 FT3 Low ACETYLENE F P IH G 330.00 FT3 Hi DIESEL #2 j, ,/~ ~d~h ~y/P~Do hereby ceri:if~that I I~'IV~TM L 1000.00 GAL Low uYpe or print name) - reviewed the attached hazardous materials manage- ment plan for ~ ~'~r~ l~' and that it along with (Name of Busine~ any corrections constitute a complete and correct man- agement plan for my facility. RUBEN BARTELL FARMS SiteID: 015-021-001103 = Inventory Item 0001 Facility Unit: Fixed Containers on Site PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: CENTER OF LOT CAS# 74-98-6 Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER I AMOUNTS AT THIS LOCATIONI Largest Container Daily Maximum Daily Average GAL 500.00 GAL 500.00 GAL Ii HAZARDOUS COMPONENTS I I %Wt. RS CAS# 100.00 Propane Yes 74986 TSecret S BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No N No No/ Curies F P IH / / / Hi ---- Inventory Item 0003 Facility unit: Fixed Containers on Site ~L.)LvU.VLL~.L~ L~Z-~J.VL~', / L~.I~.LSLVI/~Z.-~,.J.s £~Z-~J.Vl~ MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: E OF SHOP 25FT CAS# 8020835 STATE = TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Pure Ambient I Ambient I ABOVE GROUND TANK I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 330.00 GAL 330.00 GAL HAZARDOUS COMPONENTS oR %Wt. S CAS# 100.00 Motor Oil, Petroleum Based N 8020835 RS BioHazI HAZARD ASSESSMENTS I I TSecret Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min 2 08/02/2000 R~EN B~TELL FARMS SiteID: 015-021-001103 ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~U~V~Vl~ ~Vl~ / ~£ ~ ~Vl~ OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: NORTH END OF SHOP CAS# 7782-44-7 F STATE -- TYPE PRESS~E TEMPE~T~E CONTAINER TYPE Gas Pure Above AmbientIl AmbientI, PORT. PRESS. CYLINDER 'AMO~TS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average FT3I 230.00 FT3I 230.00 FT3 HAZ~DOUS COMPONENTS %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 RSBi°HazI HAZARDASSESSMENTS I I TSecret Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low ~ Inventory Item 0005 Facility Unit: Fixed Containers on Site ~V~Vl~ ~vl~ / ~ ~_.~.-~j ~Vl~ ACETYLENE Days On Site 365 Location within this Facility Unit Map: Grid: NORTH END OF SHOP CAS# 74-86-2 Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average FT3I 330.00 FT3 330.00 FT3 HAZARDOUS COMPONENTS %Wt. y~ CAS# 100.00 Acetylene 74862 HAZARD ASSESSMENTS TSecretINo N~S I BioHazINo Radi°active/Amount I EPANo/ Curies F P HazardsiH NFPA/// I USDOT# MCPHi 3 08/02/2000 R~EN B~TELL FARMS SiteID: 015-021-001103 ~ Inventory Item 0006 Facility Unit: Fixed Containers on Site DIESEL #2 Days On Site 365 Location within this Facility Unit Map: Grid: MIDDLE SIDE, SE, BY SHOP CAS# 68476-34-6 Li~id Pure A~ient A~ient ~OVE GRO~D T~K ~O~TS AT THIS LO~TION Largest Container I Daily Maximum · Daily Average GMI 1000.00 GM 500.00 GM ~Z~DOUS COMPONENTS ~ %Wt. S CAS# 100.00 Diesel Fuel No. 2 N 68476302 RS BioHaz) ~Z~D ASSESSMENTS I I TSecret Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low 4 08/02/2000 RUBEN BARTELL FARMS SiteID: 015-021-001103 Fast Format ~ Notif./Evacuation/Medical Overall Site -- Agency Notification 01/09/1997 CALL 911 - PHONES INSIDE SHOP & HOMES. ~ Employee Notif./Evacuation 01/06/1993 VERBALLY NOTIFY THEM - HOWEVER, IT'S JUST ME AND MY DAD. Public Notifo/Evacuation 01/06/1993 VERBALLY Emergency Medical Plan 01/09/1997 NEAREST HOSPITAL MERCY HOSPITAL KMC FIRST AID KIT INSIDE SHOP. -5- 08/02/2000 F RUBEN BARTELL FARMS SiteID: 015-021-001103 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site --Release Prevention 01/06/1993 ENCLOSED METAL SHED WITH DOOR. Release Containment 01/06/1993 NEW PLUMBING REPLACEMENT IF NEEDED. SHOVELS WITH DIRT. TRACTORS WITH SCRAPERS. -- Clean Up 01/06/1993 LANDFILL AT BUTTON-WILLOW. Other Resource Activation 6 08/02/2000 RUBEN BARTELL FARMS SiteID: 015-021-001103 Fast Format ~ Site Emergency Factors Overall Site -- Special Hazards 01/09/1997 SEASONAL USE OF PESTICIDES, OCCASIONALLY STORED IN SMALL METAL SIDED SHED EAST OF SHOP BLDG. --Utility Shut-Offs 01/09/1997 A) GAS - SOUTH OF HOUSE B) ELECTRICAL - NORTH OF HOUSE C) WATER - SOUTH OF HOUSE AND BACKYARD OUTSIDE (DOMESTIC WELL) D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 01/06/1993 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS, 300 GALLON PRESSURE WATER SOURCE. Building Occupancy Level -7- 08/02/2000 RUBEN BARTELL FARMS SiteID: 015-021-001103 Fast Format ~ Training Overall Site -- Employee Training 01/06/1993 THERE IS ONLY MY DAD AND MYSELF AT THIS LOCATION WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: GO TO SAFETY MEETINGS AT KERN COUNTY FARM BUREAU SEMINARS. SET UP BOX FOR MSDS SHEETS AT THE EAST DOOR OF SHOP. READ MSDS INFORMATION WHEN IT COMES IN. -- Page 2 I ~ Held for Future Use I Held for Future Use 8 08/02/2000 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~U,-- ~% INSPECTION DATE ~"/' 7 / ADDRESS ) S-Do ~-,r'~c_-- ~ PHONE NO. FACILITY CONTACT BUSINESS IDNO. 15-210- [ INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program {~ Routine ~J-Combined [21 Joint Agency ~ Multi-Agency [21 Complaint [2] Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures ?LC"~ ~::f'~3~O~ VC'~,cc~ Emergency procedures adequate Aq- ~t'~OP~,~t~ Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardousAwaste on site?: ~'~ Questions regarding this inspection? Please call us at (661) 326-3979., '~ B~sineSs ~;ite Respon~ble Party White- Env. Svcs. Yellow- Station Copy Pink- Business Copy Inspector: CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 Section 4: Hazardous Waste Generator Program EPA ID # t~1 Routine ,)~LCombined {~1 Joint Agency ~1 Multi-Agency 1~ Complaint ~l Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA 1D Number (Phone: 916-324-1781 to ohtain EPA ID #) ~_OcC~-~w,,,l Authorized for waste treatment and/or storage /tk-~ Reported release, fire, or explosion within 15 days of occurance ,~¢O.9r~q'/.-Zk-F~-~'~ o,'xJ Established or maintains a contingency plan and training Hazardous waste acctlmtllation tirne fi'amos Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed ~vhen not in use Weekly inspection of storage area Ignitable/reactive wast} located at least 50 feet from property line Secondary containment provided Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste Proper management of lead acid batteries including labels Proper management of' used oil filters Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retaius manifests tbr 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts fi)r 3 years Determines if waste is restricted fi'om land disposal C=Compliance V=Violation Inspector: Office of Environmental Services (805) 326-3979 Business Site Responsible Party \Vhite - Env. Svcs. Pink - Business Copy ~ Bakersfield Fire Dept. ~FFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 9330 Date Completed I//3/"=/'7 Business Namei ~o$c~ ~A~r~c~ Location: / Soo Cdr-r:'~~ Business Identification No. 215-000 ! I o'3 (Top of Business Plan) Station No. H^z-,~,~-r' Shift Inspector Arrival Time: 1 '3. 3.0 Departure Time: 1 4- ! 5"' Inspection Time: ~ S' ,,.,,,J Adequate Inadequate Adequate Inadequate Address Visable 12:1'" [] Emergency Procedures Posted~ [] Correct Occupancy ~ El Containers Propedy Labled Verification of Inventory Materials I~ [] Comments: Verification of Quantities ~ [] Verification of Location ~ [] Verification of Facility Diagram [] [] Proper Segregation of Uatedal ~ [] Housekeeping ~ r'l Fire Protection ~ [] Comments: Electrical ~ [] Comments: Verification of MSDS Availablity ~ [] Number of Employees: UST Mgnitodng_ Program [] [] Comments: Verification of Haz Mat Training ~ [] Permits [] [] Comments: ~:~,,~z~ [o~.E,~J ~ ,46- ~.~,',-~,/- 8pill Control [] [] Hold Open Device [] [] Verification of Hazardous Waste EPA No, Abbatement Supplies and Procedures ~ [] Proper Waste Disposal I~ [] Comments: Secondary Containment [] [] Security ~ [] Special Hazards Associated with this Facility: ~E~o~c u~- ~ ?~'~¢,0~-.~ oc'o~,o,,,,,u.y Violations:. £ / L / All Items O.K Busin;ss Owner/Manag;; PRINT NAME ' '1' SIGi~ATURE -- Correction Needed [] White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy U_ 02/23/96 RUBEN BARTELL FARMS 215-000-00110,3 -lAN ~ ~cJ97 1 Overall Site with 1 Fac. Unit iud.~ ~ge General Information '~~ Location: 1500 COFFEE RD Map:102 Naz:2 Type: 3 City : BAKERSFIELD Grid: 28A F/U: 1 AOV: 0.0 Contact Name Title Contact Name Title CURTIS BARTELL / RUBEN BARTELL / SON Business Phone: (805) 589-3369x Business Phone: (805) 589-9259x 24-Hour Phone : (805) 589-3369x 24-Hour Phone : (805) 589-9259x Pager Phone : ( ) - x Pager Phone : ( ) - x AdminiStrative Data Mail Addrs: 1500 COFFEE RD D&B Number: City: BAKERSFIELD State: CA Zip: 93308- Comm Code: 215-065 COUNTY STATION 65 SIC Code: 0131 Owner: RUBEN BARTELL Phone: (805) 589-3369 Address: 1500 COFFEE RD State: CA City: BAKERSFIELD Zip: 93308- Summary ................. REMOVED UST 2/91 02/23/96 RUBEN BARTELL FARMS 215-000-001103 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Max Qty MCP 02-001 PROPANE Gas 500 High · Fire, Pressure, Immed Hlth GAL 02-005 ACETYLENE Gas 330 High · Fire, Pressure, Immed Hlth FT3 02-004 OXYGEN Gas 230 Low · Fire, Immed Hlth, Delay Hlth FT3 02-006 DIESEL #2 Liquid 1000 Low · Fire, Immed Hlth, Delay Hlth GAL 02-003 MOTOR OIL Liquid 330 Minimal · Fire, Delay Hlth GAL 02/23/96 RUBEN BARTELL FARMS 215-000-001103 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02'001 PROPANE Gas 500 High · Fire, Pressure, Immed Hlth GAL CAS #: 74-98-6 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: HEATING Daily Max GAL I Daily Average GAL I Annual Amount GAL ..- 500 I 500.00 5,000.00 Storage I Press T TempI Location PORT. PRESS. CYLINDER I Above I AmbientlCENTER OF LOT -- Conc Components MCP -~Guide 100.0% IPropane IExtreme I 22 02-005 ACETYLENE Gas 330 High · Fire, Pressure, Immed Hlth FT3 CAS #: 74-86-2 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3I Daily Average FT3 I Annual Amount FT3 330 ~ 330.00 990.00 StorageI Press T TempI Location PORT. PRESS. CYLINDER IAbove ~AmbientlNORTH END OF SHOP -- Conc Components MCP ---TGuide 100.0% IAcetylene ]High ~ 17 02-004 OXYGEN Gas 230 Low ~ Fire, Immed Hlth, Delay Hlth FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3I Daily Average FT3 I Annual Amount FT3 230 ~ 230.00 690.00 Storage~ Press T TempI Location PORT. PRESS. CYLINDER Iabove IAmbientlNORTH END OF SHOP -- Conc Components MCP ----~Uide 100.0% IOxygen, Compressed ILow [ 14 02/23/96 RUBEN BARTELL FARMS 215-000-001103 Page 4 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-006 DIESEL #2 Liquid 1000 Low · Fire, Immed Hlth, Delay Hlth GAL CAS #: 68476-34-6 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL -- Daily Maxl,000GALIm Daily Average500.00GAL I Annual Amount4,000~00GAL -- Storage ~ Press T Temp~ Location ABOVE GROUND TANK I AmbientlAmbientlMIDDLE SIDE, SE, BY SHOP -- Conc~ Components ~ MCP -~Guide 100.0% IDiesel Fuel No. 2 IModeratel 27 02-'003 MOTOR OIL Liquid 330 Minimal · Fire, Delay Hlth GAL CAS #: 8020835 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GAL Daily Average GAL Annual Amount GAL 330 I 330.00 I 1,000.00 StorageIIPress T Temp Location ABOVE GROUND TANK IAmbientlAmbientlE OF SHOP 25FT -- ConcI Components MCP ---~uide 100.0% IMotor Oil, Petroleum Based Minimal I 27 02/23/96 RUBEN BARTELL FARMS 215-000-001103 Page 5 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency'Notification CALL 911 <2> Employee Notif./Evacuation VERBALLY NOTIFY THEM - HOWEVER, IT'S JUST ME AND MY DAD. <3> Public Notif./Evacuation VERBALLY <4> Emergency Medical Plan NEAREST HOSPITAL. MERCY HOSPITAL KMC 02/23/96 RUBEN BARTELL FARMS 215-000-001103 Page 6 00 - Overall Site <E> Mitigat ion/Prevent/Abatemt <1> Release PreventiOn ENCLOSED METAL SHED WITH DOOR. <2> Release Containment NEW PLUMBING REPLACEMENT IF NEEDED. SHOVELS WITH DIRT. TRACTORS WITH SCRAPERS. <3> Clean Up LANDFILL AT BUTTONWILLOW. <4> Other Resource Activation 02/23/96 RUBEN BARTELL FARMS 215-000-001103 Page 7 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards EXCESSIVE WASTE O~CCUMULATION ON EAST SIDE OF SHOP. ALSO PILE OF USED BATTERIES, IJ~OPER USE OF RESTRICTED MATERIAL, PESTICIDE CONTAINERS, AND GENERALLY~,~OR HOUSEKEEPING, WASTE BARRELS ARE COMPLETELY CORRODED THROUGH AND LEA,~G. THERE IS A SCRAP IRON JUNK AREA EAST OF THE SHOP WHERE A PORtaBlE DIESEL FUEL TANK TRAILER IS OFTEN LOCATED. ! <2> Utility Shut-Offs A) GAS - SOUTH OF HOUSE B) ELECTRICAL - NORTH OF HOUSE~ C) WATER - SOUTH OF HOUSE AND BACKYARD OUTSIDE D) SPECIAL .-.NONE ............. E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS, 300 GALLON PRESSURE WATER SOURCE. FIRE HYDRANT - 1 1/2 W/100 PSI WATER FAUCETS - EAST SIDE OF COFFEE ROAD <4> Building Occupancy Level 02/23/96 RUBEN BARTELL FARMS 215-000-001103 Page 8 00 - Overall Site <G> Training <1> Employee Training THERE IS ONLY MY DAD AND MYSELF AT THIS LOCATION WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: GO TO SAFETY MEETINGS AT KERN COUNTY FARM BUREAU SEMINARS. SET UP BOX FOR MSDS SHEETS AT THE EAST DOOR OF SHOP. READ MSDS INFORMATION WHEN IT COMES IN. <2> Page 2 <3> Held for Future Use <4> Held for Future Use 02/23/96 RUBEN BARTELL FARMS 215-000-001103 Page 9 00 - Overall Site <M> Inspections 06/17/88 OK / / J ESPERICU 01/14/93 BY COUNTY INSPECTOR / / 02/23/96 RUBEN BARTELL FARMS 215'-000-001103 Page 10 00 - Overall Site <M> Inspection Summary 06/17/88 OK / / HAVE WASTE OIL HAULED OFF AND LABEL YOUR FUEL AND OIL TANKS. PREPARE A HAZARD COMMUNICATION PLAN. THIS IS A RELATIVELY SMALL FARMING BUSINESS OPERATED BY FATHER AND SON. THERE IS EXCESSIVE ACCUMULATION OF JUNK PARTS AND HAZARDOUS WASTE OIL AND BATTERIES. BUSINESS HAS BEEN IN PRACTICE OF SUPPRESSING DUST WITH WASTE OIL. J ESPERICU 01/14/93 BY COUNTY INSPECTOR / / UPDATE INVENTORY OF DIESEL. LABEL DIESEL. DOT PLACARDS. 31/22/93 RUBEN BARTELL FARMS 215-000-001 ~3 ~ Page Overall Site with 1 Fac. Unit FEB General Information Location: 1500 COFFEE RD Map: 102 Hazard: Low Community: COUNTY STATION 65 Grid: 28A F/U: 1AOV: 0.0 Contact Name Title Business Phone 24-Hour Phone- CURTIS BARTELL (805) 589-3369 x (805) 589-3369 RUBEN BARTELL SON (805) 589-9259 x (805) 589-9259 Administrative Data Mail Addrs: 1500 COFFEE RD D&B Number: City: BAKERSFIELD State: CA Zip: 93308- Comm Code: 215-065 COUNTY STATION 65 SiC Code: Ol'~ ~ Owner: RUBEN BARTELL Phone: (805) 589-3369 Address: 1500 COFFEE RD State: CA City: BAKERSFIELD Zip: 93308- Summary REMOVED UST 2/91 reviewed the attached hazardo~ m~erial5 manage- ment plan for ~o~_~- ~! ~r.a~d that it along with any ~rre~io,ns constitute a complete and ~ue~ m~- ~ement piar, ~; my facili~. 01/22/93 RUBEN BARTELL FARMS 215-000-001103 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Quantity MCP 02-001 PROPANE GaS 500 High · Fire, Pressure, Immed Hlth GAL 02-005 ACETYLENE Gas 330 High · Fire, Pressure, Immed Hlth FT3 02-004 .OXYGEN Gas 230 Low · Fire, Immed Hlth, Delay Hlth FT3 02-003 MOTOR OIL Liquid 330 Minimal · Fire, Delay Hlth GAL 01/22/93 RUBEN BARTELL FARMS 215-000-001103 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-001 PROPANE Gas 500 High' · Fire, Pressure, Immed Hlth GAL CAS #: 74-98-6 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: HEATING Daily Max GALI Daily Average GAL ] Annual Amount GAL 500 ~ 5'00.00 5,000.00 Storage Press T Temp Location PORT. PRESS. CYLINDER IAbove IAmbiontlCENTER OF LOT -- Conc Components MCP ---~uide 100.0% IPropane IExtreme I 22 02-005 ACETYLENE Gas 330 High · Fire, Pressure, Immed Hlth FT3 CAS #: 74-86-2 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3I Daily Average FT3 I Annual Amount FT3 330 ; 330.00 990.00 StorageI Press T TempI Location PORT. PRESS. CYLINDER Iabove .~AmbientlNORTH END OF SHOP -- ConcI Components I MCP ---TGuide 100.0% IAcetylene IHigh ! 17 02-004 OXYGEN Gas 230 Low · .Fire, Immed Hlth, Delay Hlth FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3 ~ Dailyj Average FT3 T Annual Amount. FT3 230 I 230.00 690.00 / StorageI Press T TempI Location PORT. PRESS. CYLINDER IAbove ~AmbientlNORTH END OF SHOP -- Conc, Components I MCP ----~Guide 100.0% IOxygen, Compressed ~Low-- ~ 14 01/22/93 RUBEN BARTELL FARMS 215-000-001103 Page 4 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-003 MOTOR OIL Liquid 330 Minimal · Fire, Delay Hlth GAL CAS #: 8020835 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GAL Daily Average GAL Annual Amount GAL 330 I 330.00 I 1,000.00 Storage~~Press T Temp Location ABOVE GROUND TANK IAmbientlAmbientlE OF SHOP 25FT -- Conc~ Components MCP ---TGuide 100.0% IMotor Oil, Petroleum Based Minimal I 27 01/22/93 RUBEN BARTELL FARMS 215-000-001103 Page 5 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation VERBALLY NOTIFY THEM - HOWEVER, IT'S JUST ME AND MY DAD. <3> Public Notif./Evacuation VERBALLY <4> Emergency Medical Plan NEAREST HOSPITAL. MERCY HOSPITAL KMC 01/22/93 RUBEN BARTELL FARMS 215-000-001103 Page 6 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention ENCLOSED METAL. SHED WITH DOOR. <2> Release Containment NEW PLUMBING REPLACEMENT IF NEEDED. SHOVELS WITH DIRT. TRACTORS WITH SCRAPERS. <3> Clean Up LANDFILL AT BUTTONWILLOW. <4> Other Resource Activation 01/22/93 RUBEN BARTELL FARMS 215-000-001103 Page 7 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards EXCESSIVE WASTE OIL ACCUMULATION ON EAST SIDE OF SHOP. ALSO PILE OF USED BATTERIES, IMPROPER USE OF RESTRICTED MATERIAL, PESTICIDE CONTAINERS, AND GENERALLY POOR HOUSEKEEPING, WASTE BARRELS ARE COMPLETELY CORRODED THROUGH AND LEAKING. THERE IS A SCRAP IRON JUNK AREA EAST OF THE SHOP WHERE A PORTABLE DIESEL FUEL TANK TRAILER IS OFTEN LOCATED. <2> Utility Shut-Offs A) GAS - SOUTH OF HOUSE B) ELECTRICAL - NORTH OF HOUSE C) WATER - SOUTH OF HOUSE AND BACKYARD OUTSIDE D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS, 300 GALLON PRESSURE WATER SOURCE. FIRE HYDRANT - 1 1/2 W/100 PSI WATER FAUCETS - EAST SIDE OF COFFEE ROAD <4> Building Occupancy Level 01/22/93 RUBEN'BARTELL FARMS 215-000-001103 Page 8 00 - Overall Site <G> Training <1> Page 1 THERE IS ONLY MY DAD AND MYSELF AT THIS LOCATION WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: GO TO SAFETY MEETINGS AT KERN COUNTY FARM BUREAU SEMINARS. SET UP BOX FOR MSDS SHEETS AT THE EAST DOOR OF SHOP. READ MSDS INFORMATION WHEN IT COMES IN. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS DIVISION 2130 "G" STREET BAKERSFIELD, CA. 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [~'J" BUSINESS NAME ~ ~C__~ ~:~e_//' ~'"-~ f- C'~ %o FACILITY NAME ~. O~:be__C~" ~'--'~(-'~e_~.~ ~-Q¢ rY~--~ NATURE OF BUSINESS' ~'-'-O,C m SIC CODE ~l ~ ( DUN & BRADSTREET NUMBER MAILING ADDRESS I~Ok'~ ~_~'"b~-~""¢ ¢ CITY' (~e ~-1~\ ¢___~0~ STATE ('"0_.~ ZIP EMERGENCY CONTACTS NAME ~___O C ~"% ~o-~-'~ ~'--k'~, TITLE BUSINESS PHONE ~?:~°t- %% ~ ~ 24-HOUR PHONE BUSINESS PHONE ~%q~ ~%~ 24-HOUR PHONE Seplemi~er 30, 1992 PEGION¥ LIEPC STANOARDFORM BAKERSFII D CITY FIRE DEPAR ENT ?" HAZARDOUS MATERIALS INVENTORY Page_of__ CHEMICAL DESCRIPTION 1) INVENTORY STA~S: New [~ddition [ ] Revision [ ] Deletion [ ] Check if chemi~ is a NON ~DE SECR~ [~DE S'ECR~ [ ] 2, Oommon.~.: ~)'[~-~ 4 3) ~T*(option.) 4) .HYS~CAL & H~L~ ~ .HYS~CAL H~L~ H~RD CA~GORIES Fire ~ Reactive { ] Sudden Rele~e of Pressure [ ] Immediate Heath (Acme) 7) AMOUNT AND TIME AT FACIE~ UNITS OF M~RE 8) STOOGE CODES M~imum D~lyAmount: '~/~ I~ [ ] g~ ~ ~3 [ ] Average Daily Amount: ~~*~( cudes [ ]~ b) Pressu.: Annu~ Amount: c) Tem~r~ure: ~gest Size ~ontmner: · Days On SRe ~ Circle~ich Months: ~AII~, J, F, M, A, M, J, J, A, S, O, N, D chemi~ com~nen~ or ~y'AHM com~nents 2). [ ] 3). [ ] 10) Location CHEMICAL DESCRI~ION 1) IN~NTORY STA~S: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemi~ is e NON ~DE SECR~ [ ] ~DE SECR~ [ ] 2) Common N~e: 3) ~T · (optionN) Chemic~ Name: AHM [ ] CAS 4) PHYSICAL & H~L~ PHYSICAL H~L~ H~RD CA~GORIES Fire [ ] Reactive [ ] Sudden Rele~e of Pressure [ ] Immedi~e Health (Acme) [ ] ~layed He~th (Chronic) [ ] 5) WASTE C~SSIFICATION (~digit code from DHS Fo~ 8022) USE CODE 6) PHYSICAL STATE Solid [ ] ~quid [ ] G~ [ ] Pure [ ] Mi~um [ ] W~te [ ] R~iosmive [ ] 7) AMOUNT AND TIME AT FAClU~ UNITS OF M~SURE 8) STOOGE CODES M~imum Daily Amount: lbs [ ] gN [ ] ~3 [ ] N Cont~ner: Average Duly Amount: cudes [ ] b) Pressure: Annu~ Amount: c) Temper~um: ~gest Size Cont~ner: · Days On S~e Cimle~ich Months: NIYe~, J, F, M, A, M, J, J, A, S, O, N, D 9) MITRE: ~st COMPONENT CAS · % ~ AHM the throe most h~dous 1). [ ] chemi~ com~nen~ or ~y ~M com~nents 2) [ ] 3) [ ] 10) Lo~ion ce~'~ under pen~ of law, ~at I have personally examin~ and am f~ili~ with ~e infomagon submi~ on ~is ~d submi~ info.aEon is ~e, accurate, and complete. PRI~ ~ame & Ti~e of A~hodz~ Company Represenm~ve Signa~re Dam CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT 2101 H STREET S. D. JOHNSON BAKERSFIELD, 93301 FIRE CHIEF 326-3911 Dear Business Owner: This notice is meant to act as a reminder that the California Health and Safety Code, Chapter 6.95, requires any handler of hazardous materials to revise their hazardous materials business plan within 30 days of any one of the following events: (1) A 100 per cent or more increase in the quantity of a previously-disclosed material. (2) Any handling of a previously-undisclosed hazardous material, subject to the inventory requirements of Chapter 6.95. (3) Change in business ownership. ( ) hange in bu iness address. , (5) Change of business name. Any questions regarding these required revisions, please call th~azardous Materials Division at (805)326-3979. Sincerely yours, /RH~;dEc;uHs Ul~lYaterials Coo rd i nator KERN COUNTY FIRE DEPARTMENT "~' ~?e" PREPI SPECTION REPORT c4- ¥ FILE NO. ~ '~ New Inspection Purge E = EXEMPT m ' PRIMARY I · D = DELETE S = SECONDARY J GENERAL USE CLASS ........... ~ ............. ....... CLASS ~ANAOER ~j~'~ BLDGS. STORIES RESPONSIBLE ~ J SHIFT BUSINESS HOME ~ ~ ~ ~ERGENCY DATE OF J J OWNER PHONE PHONE ~::i ?j ~:~,~i:; i~ i::~q,::, ::~:;:i~: :~:~:::i ::::i~ i::;::i ~,:i :~:~ LAST INSP. I I Disposition Sym. I -.Corrected 2- Will Correct 3- V.N. Issued. Call Back NecessQry 4- Citation Issued 5- Referred BUILDING ~P~R~ /ED )~SP. REMARKS: YES NA NO SYM 1. Exit Doors-Hardware Exit Signs-Lighted 1 3. ~ Spa~n~-Seatln~ ~ . __- . . ~ ~ X ~ 4. Occupant Load Signs " 4 ~~ a ~ ~D~ q. 5. Vertical Openings 5 ' COMMON HAZARDS 6. Electrical 6 ~. ~~ ~~~ 7. Furnace/BoilerRooms-HeatingEquipment 7 ~~ ~{~ ~ T~ ~~{[g~ ~ 8. Cooking Equipment 8 - - . 9. Decorations-Curtains-Drapes9 g. 0 ~. 10. Housekeeping-Trash-Weeds ]0 '' FIRE PROTECTION EQUIPMENT , 11. Fire Extinguishers 11 ~K ~ 12. Automatic Extinguishing S~sfems 12 ' ' 13. Wef-Dr~ S~an~ipes 13 14. Alarm S~s~lem 14 15. Fire Assemblies-Fire Walls 15 16. Fire Sprinkler Records OTHER HAZARDS 17. Grease Hooes & Ducts ~ , 18. WamJnO Signs 19. Com~resse~ Gas 20. Offer (see Remarks) HAZARDOUS MATERIALS 21. Training Records 21 22. MSDS'S Available 22 23. C~emicallnvenfor~ 23 ,X ~ 24. Labeling 24 ~ ~ ~ TOTAL TIME TO COMPLETE INSPECTION ~ ~EOULAR INSP. , ~WNER / MANAGER RE-INSPECTION ~ MISC.,~SeECT,O~ ~~ ~ ~:7{~?t~ {PR~V~IIO~ O~[Y} ~ ~s~ClO~~ ' ~ s.}~ MISC. INSP. ~ A = ANNUAL (PREVENTION ONLY) MONTH o: ODD YEAR GRANTED OF RE-INSPECTION ~?,~ .............. ~ DENIED X - PREPLAN UPDATED KCFD ~91 CATALOG ~9215 OFFICE %~ ~'~l~tJ~'~ ,.z.- PREPLA SPECTION REPORT L,...,~\ '~ ........ ' P ~ PRIMARY J D ~ DELETE . s ~ SECONDARY J J' :~,~,J ' s ~ ~ ~m D ~ DELETE GENERAL USE LOCATION 0~ ~ ~ S~ ~ , ,~ : ~ CITY ...~K~ OCCUPA,CY MANAGERI:~: PHONE I:~:~ ~:~ ; ~-~,;::1 BLDGS. STORIES DICTION RESPONSIBLE ~ j SHIFT BUSINESS HOME ~ ~ERGENCY J j ' ' ,~,, "~-,~ DATE 0F OWNER PHONE PHONE ~ ;' '~;~ ~' :~:¢,~, LAST INSP. Disposition Sym. 1 - Corrected 2- Will Correct 3- V.N. Issued. Call Back Necessary 4 - Citation Issued 5- ReFerred BUILDING APP ~EO O~SP. REMARKS: YES NA NO SYM 1. Exit Doors-Hardware Exit Signs-Lighted 2. Exit Corridors ............ 4. Occupant Load Sign, ~S~.~SU nA~ F~,~FA ~- 5. Vertical Openings co oN, Z .DS 6, Electrical 6 L 7. Furnace/BoilerRooms-HeatingEquipment 7 ~a~ 8. Cooking Equipment 8 9. Decorations-Curtains-Drapes9 J~, 0 ~, ¢ LA ~P;~'~ 10. Housekeeping-Trash-Weeds 10 ~/%~1/~ ~,~' )" FIRE PROTECTION EQUIPMENT - - ., 11. Fire Extinguishers ii ~ ~ ~) ~, ~ ~) [~ .~,[ ~ ~ 12. Automatic Extinguishing S~stems 12 13. Wet-Dry Standpipes 13 14. Alarm S~s~fem 14 15. Fire Assemblies-Fire Walls 15 16. Fire Sprinkler Records 16 OTHER HAZARDS 17. Grease Hoo~s & Ducts 18. Warning Signs 19. Compresse~ Gas 20. Other (see Remarks) HAZARDOUS MATERIALS 21. Training Records 21 22. ~SDS'S Available 22 23. Chemicallnventory 23 X [ 24. Labeling 24 ~ ~ TOTAL TIME TO REGULAR INSP. COMPLETE INSPECTION MANAGER RE-INSPECTION ~ M~SC: INSPECTION J:;~i:'f; ~?/J" MISC. INSP. ~ (PREVENTION ONLY) ~ y SH A = ANNUAL MONTH J (PREVENTION ONLYJ INSPECTION DUEl ~ ~ J o = ODD YEAR E = EVEN YEAR CLEARANCEDENiED ~ SCHEDULED DATE~,~-,~:~,: ~:~,~:: :::~,,,::,,,~/:,~ ~,~ ~,~,~ ,:: ~ GRANTED OF RE-INSPECTION X-PREPLAN UPDATED ~ KCFD ~97 CATALOG ~9215 INSPECTION UNIT · RAZ~V~OUS ~tTERI~LS XNV~N'ZOR¥ ,,, Standard ~Business [ ] ~ ~ ~ ~ 4'. ~ ~' ~ ' Page of , ITr~ T~ i' ~ax Average i A~t ~ I Neasure C~t C~t C~t Use X ~ ' }C~ C~ ~t ~t , ESt Units T~ Press T~ C~ ~t I' I ~1 ~ .~ I ..... I I[~]FJre (~ ]~tay~~eatth ' ~S N~r, I ~ C~, & CAS .... I[: ]Reactivity, t ]S~ Ret ease of Pressure * Oays ~ S Jt~, [~L~ i I C~nt & CAS , " 'v=~ Re~ease Of Pressure ~ Days ~ ~ , ~ I ' cAS ~r I, c~t & cas [ ]Reactivity '[ ~S~ Retease ot Pr'%syr~ ~ Oa~ ~ Si'te [~ ~ I I C~t & CAS I I [ ] l~iate ?~tth I L~bti~ C~t & us . I [[ ]Reactivity ~ 'lS~ Release ~of Pressure ~ Da~ ~ Site' [ ] I I C~t I CAS I [ ]l~iate H~th [ L~ati~ , [ I: [ C~t I ~S I I I[, ]Fire [ ]~tay~ Health ~S N~r [ C~t & ~S I[ ]Reactivity [ .]S~ Retease of Pressure ~ 'Days ~ Site [ ] [ C~t & ~S .08/05/92 RUBEN BARTELL FARMS 215-000-001103 ' Page Overall Site with 1 Fac. Unit General Information I LOcation: 1500 COFFEE RD Map: 102 Hazard: Low Community: COUNTY STATION 65 Grid: 28A F/U: 1 AOV: 0.0 [ Contact Name i Title i BUsiness Phone 24-Hour Phone Administrative Data Mail Addrs: 1500 COFFEE RD D&B Number: City: BAKERSFIELD State: CA Zip: 933~-O8 Comm Code: 215-065 COUNTY STATION 65 SIC Code: Owner: RUBEN BARTELL Phone: (~O~9~-~3~ Address: 1500 COFFEE RD State: CA City: BAKERSFIE~~"~~ Zip: 933~-O~ 08/05/92 RUBEN BARTELL FARMS 215-000-001103 Page 2 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-001 PROPANE ? 500 High GAL CAS #: Trade Secret: No Form: Unknown Type: Pure Days: Use: FUEL Daily Max GAL I Daily Average GAL I Annual Amount GAL 500 ~ 0.00 5,000.00 Storage Press Temp Location I I -- Conc Components MCP List 100.0% IPropane IExtreme I 02-002 UNLEADED GASOLINE /~ ~ ~--~? ................... ~ ('~,,~-~0~'~ Moderate Form: UnknoF Type:~ure Days: Use: FUEI / , · -- Daily/Max GAL / ~ ~rage GAL ~nnual Amount GAL --- Storage '~ , Press~Tem~ ~ / /~ Location ~.NDER ~U.~'~ TANK ~ E COR SHOP -- Conc . Components MCP List ~ Q3~Ga s.o 1 i ne ~ Modera te } 02-003 MOTOR OIL ? 330 Minimal · GAL CAS #: Trade Secret: No .Form: Unknown Type: Pure .Days: Use: LuBRIcANT Daily Max GALI Daily Average GAL I Annual Amount GAL -- 330 ~ 0.00. 1,000.00 Storage Press Temp Location DRUM/BARREL-METALLIC I 'T IE OF SHOP 25FT -- Conc~ Components ~ MCP ---TList. 100.0% IMotor Oil, Petroleum Based 08/05/92 RUBEN BARTELL FARMS 215-000-001103 Page 3 00 -Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification <2> Employee Notif./Evacuation <3> Public Notif./Evacuation <4> Emergency Medical Plan NEAREST HOSPITAL. 08/05/92 RUBEN BARTELL FARMS 215-000-001103 Page 4 00 - Overall Site <E> Mitigation/Prevent/A~atemt <1> Release Prevention <2> Release Containment <4> Other Resource Activation 08/05/92 RUBEN BARTELL FARMS 215-000-001103 Page 5 00 -.Overall Site <F> Site Emergency Factors <1> Special Hazards EXCESSIVE WASTE OIL ACCUMULATION ON EAST SIDE OF ~SHOP. ALSO PILE OF USED BATTERIES, IMPROPER USE OF RESTRICTED MATERIAL, PESTICIDE CONTAINERS, AND GENERALLY POOR HOUSEKEEPING, WASTE BARRELS ARE COMPLETELY CORRODED THROUGH AND LEAKING. THERE IS A SCRAP IRON JUNK AREA EAST OF THE SHOP WHERE A PORTABLE DIESEL FUEL TANK TRAILER IS OFTEN LOCATED. <2> Utility Shut-Offs A) GAS - SOUTH OF HOUSE B) ELECTRICAL - NORTH OF HOUSE C) WATER - SOUTH OF HOUSE AND BACKYARD OUTSIDE D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE pROTECTION - ?????????????? FIRE HYDRANT - ????????????? <4> Building Occupancy Level 08/05/92 RUBEN BARTELL FARMS 215-000'001103 Page 6 ,_ 00 - Overall Site <G> Training <1> Page 1 WE HAVE ?? EMPLOYEES AT THIS FACILITY DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE? BRIEF SUMMARY OF TRAINING: <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use · I~ZARDOUS ~AtT~RIALs INVENTORY · ~ Fa~ and AgricUI~ture ~ Standard Business " Page .. ~f .~,. ~ NON - ~E SEC~T LOCATION:. _ /~0 Cm ~e ~ ~ ~D~SS: -/~ ~m ~ ~ ~ ST~ IND. C~SS CODE: CITY, ZIP~ ~W~ ~/2 ~-~-'~ CITY, ZIP: ~~w/~, ~.?~D~ D~ ~D B~ST~ET ~BE~FEDE~ ID PHONE ~: ~D~-- ~gq-- 33A~ ' PHONE .$:' 8~- ~-~-~A~ -- -- - .... - i 2 3 4 5 6 7 8 9 10 11 12 13 14 ~s ~e ~ Average ~nual ~asure ~ Days Cont Cont Cont Use ~cation ~ere ,% ~ N~s of M~ture/C~nents ~ See Inst~cttons Ph~tca~and H~lth Hazard/ C.A.S. Nu~er ,, Component ~ 1 N~ ~ C.A.a. N~ Ft~ Hazed ~ Sudden Release ~ R~ctivity ~iate ~ Delay~ of Pressure H~lth H~lth Component ~ 3 N~ & C.A.Z. N~er Ph~ical and ~lth Hazard C.A.S. Nu~er Co~onent ~ i N~ i C.A.S. N~er / . ~ Fire Hazed ~ Sudden Release ~ R~utivity ~ I~iate of Pressure H~lth H~lth Co~onent ~ 3'N~ & C.A.S. N~er ~ Ph~ical and H~lth ~zard C.A.S. N~er Component ~ I N~ & C.A.S. N~er (Check all t~t apply) Co~onent ~ 2 Na~ & C.A.S. N~er of Pressure H~lth H~lth Component ~ 3 Na~ & C.A.S. N~ Ph~cal and H~lth Hazard C.A.S. N~er .' Component ~ 1 N~ & C.A.S. N~er : (Check all t~t apply) . Component ~ 2 N~ & C.A.S. N~er ~' Fi~ Hazed ~ Sudden Release ~ R~ctivit~ ~ I=ediate ~ 0f Pressure H~lth H~lth Component ~ 3 N~ a C.A.S. N~er E~RGENcY CONTACTS ~ '~'~ ~~ ~3~ ~$-3.~' %2 'o~ - N~ ' " Title 24-~. Phone ' N~e ~tle 24 ~ Phone C~f~cat~on (~ ~D SIGN AFTER CO~"~ ~n ~. cm~T~% I certify ~der p~nlty of law t~t I hayer ~rsonally ~in~ ~d ~ f~il~ w~th the [nfo~at~on submitted ~n this ~d all attached d~ents ~d that ~ed on ~ in~i~ of those ~nd~v~d~ls res~~ible .for obtaining the ~nfo~t~on. I believe t~t ~he su~tted tnfo~at~on is t~e, acc~ate, and c~plete. ~-~ 02~ICI~ TI~ OF ~OP~R OR ~OP~R~S A~O~D HP~TI~ ' -- DA~ 12/29/92 RUBEN BARTELL FARMS 215-000-001103 Page 1 Overall Site with 1 Fac. Unit General Information Location: 1500 COFFEE RD Map: 102 Hazard: Low Community: COUNTY STATION 65 .Grid: 28A F/U: 1 AOV: 0.0 Contact Name Title Business Phone , 24-Hour Phone~ CURTIS BARTELL ( ) 589-3369 xI~ ( ) - x ( - Administrative Data Mail Addrs: 1500 COFFEE RD D&B Number: City: BAKERSFIELD State: CA Zip: 93312- Comm Code: 215-065 COUNTY STATION 65 SIC Code: Owner: RUBEN BARTELL Phone: ( ) - Address: 1500 COFFEE RD State: CA City: BAKERSFIELD Zip: 93312- Summary 12/29/92 RUBEN BARTELL FARMS 215-000-001103 Page 2 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-001 PROPANE Gas 500 High .. · Fire, Pressure, Immed Hlth GAL CAS #: 74-98-6 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: HEATING Daily Max GALI Daily Average GAL I Annual Amount GAL 500 ~ 500.00 5,000.00 Storage Press T Temp Location PORT. PRESS. CYLINDER IAbove ~AmbiontlCENTER OF LOT -- Conc Components MCP ---~Guide 100.0% IPropane IExtreme I 22 02-002 UNLEADED GASOLINE Liquid 1000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GALI Daily Average GAL I Annual Amount GAL 1,000 ~ 1,000.00 4,000.00 Storage Press T TempI Location UNDER GROUND TANK Ambient~AmbientlNE CORNER SHOP -- ConcI Components I' MCP ---TGuide 100.0% IGasoline IModeratel 27 02-003 MOTOR OIL Liquid 330 Minimal · Fire, Delay Hlth GAL CAS #: 8020835 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GAL330I~ Daily Average330.00GAL [ Annual Amount1,000.00GAL Storage Press T TempI Location ABOVE GROUND TANK Ambient~AmbientlE OF SHOP 25FT -- ConcI .ComponentsI MCP ---~uide 100.0% IMotor Oil, Petroleum Based IMinimal I 27 12/29/92 RUBEN BARTELL FARMS 215-000-001103 Page 3 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification <2> Employee Notif./Evacuation <3> Public Notif./Evacuation <4> Emergency Medical Plan NEAREST HOSPITAL. 12/29/92 RUBEN BARTELL FARMS 215-000-001103 Page 4 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention <2> Release Containment <3> Clean Up <4> Other ResoUrce Activation 12/29/92 RUBEN BARTELL FARMS 215-000-001103 Page 5 00 - Overall Site <F>.Site Emergency Factors <1> Special Hazards EXCESSIVE WASTE OIL ACCUMULATION ON EAST SIDE OF SHOP. ALSO PILE OF USED BATTERIES, IMPROPER USE OF RESTRICTED MATERIAL, PESTICIDE CONTAINERS, AND GENERALLY POOR HOUSEKEEPING, WASTE BARRELS ARE COMPLETELY CORRODED THROUGH. AND LEAKING. THERE IS A SCRAP IRON JUNK AREA EAST OF THE SHOP WHERE A PORTABLE DIESEL FUEL TANK TRAILER IS OFTEN LOCATED. <2> Utility Shut-Offs A) GAS - SOUTH OF HOUSE B) ELECTRICAL - NORTH OF HOUSE C) WATER - SOUTH OF HOUSE AND BACKYARD OUTSIDE D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - ?????????????? FIRE HYDRANT - ????????????? <4> Building Occupancy Level 12/29/92 RUBEN BARTELL FARMS 215-000-001103 Page 6 00 - Overall Site <G> Training <1> Page 1 WE HAVE ?? EMPLOYEES AT THIS FACILITY DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE? BRIEF SUMMARY OF TRAINING: <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use 12/29/92 RUBEN BARTELL FARMS 215-000-001103 Page 7 00 - Overall Site <M> Inspections 06/17/88 OK / / 12/29/92 RUBEN BARTELL FARMS 215-000-001103 Page 8 00 - Overall Site <M> Events "M" Overall List 06/17/88 OK / / HAVE WASTE OIL HAULED OFF AND LABEL YOUR FUEL AND OIL TANKS. PREPARE A HAZARD COMMUNICATION PLAN. THIS IS A RELATIVELY SMALL FARMING BUSINESS OPERATED BY FATHER AND SON. THERE IS EXCESSIVE ACCUMULATION.OF JUNK PARTS AND HAZARDOUS WASTE OIL AND .BATTERIES. BUSINESS HAS BEEN IN PRACTICE OF SUPPRESSING DUST WITH WASTE OIL. 56.42 VICTOR STREET .... BAK~.RSFIE~,D. CA 9s3o8 . , (803) 86~-276~ iO~/~. ~. r~/ ~r~ ~, ~. RECEIVE [BUSINESS ~A~E -- ' NOV Ans'd ............ HAZARDOUS ~ATERI ALS ~ BUSINESS PL-AN' AS A ~HOLE INS~UCTIONS: ; - - - SFP 1 9 1987 ]. To avoid further action, return this fo~m by 2. TYPE/PRINT ANSWERS IN ENGLISh. 3. Answer the questions below'fo~ the bus/ness as a ~hole, 4. Be as brief and concise as possible. S~CTION 1: BUSINESS IDB~IFICATION DATA SECTION 2: E~RGENCY NOTIFICATIONS : ,' In case of an emergency involving the release o~ .threatened ~elease o[ a hazardous material, ca11911 and 1-800-852-~550 or 1-916-42~-4341. This ~ill notify . your local five department and the State O~fice of: Eme~genc~ ,Sevviees .as ~equi~ed b~" la~. · -'. E~PLOYEES TO NOTIFY IN CASE 0F E~ERGENCY: ,' : N~E AND TITLE : DURING B~S.' 'HRS: ~' : AFTER 'BUS,~' HRS',' 8B~O~ 8~ ~OO&~O~ O~ ~[~[~ 8~-0~8-~OB B~8[~88 ~8 ~ ~Ob~ B. ELECTRICAL: ' W~TA ,~ ~ h~/~ D. SPECIAL: / E. LOCK BOX: YES /~ IF YES, LOCATIOn: IF YES, DOES IT CoNTAiN SITE PLANs? YES / NO ~SDSS? YES / NO FLOOR PLANS? YES / NO KEYS? .YES / NO -Over- HMCU-4 SECTION ~4~I~IVA~.~. SPONSE TEAM FOR BUSINESS AS A WHOLE ~.'~, SECTION 5: LOCAL E~E~GENCY MEDICAL ASSIST~CE ~OR YOUR BUSINESS AS A ~HOLE SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE 'REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS M~TERIALS: .... ' .................................. ":-.,~YES NO ~S NO B. PROCEDURES FOR COORDINATING ACTIVITIES /,,.~J,' WITH RESPONSE AGENCIES: .......................... ~ YESf NO ~ES NO C. PROPER USE OF SAFETY EQUIPMENT: .................. YES NO ~._~_NO D. EMERGENCY EVACUATION PROCEDURES: ................. YES NO YF~ NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES NO YES NO/~ I,, ~.~ ~ , cer'tify that the above information is accurate. I understand that this Information will be used to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that'inaccurate information constitutes perjury. ' '~.' H?4CU - 4 FARM & AGRI cULTURE HAZARDOUS MATERI ALS I NVENTORY BUSINESS NAME: V~Cr) /~'Yg'Tf OWNER NAME: FACILITY UNIT ADDRESS: '/~0 Co-~F~ ~ ADDRESS:' ~~~ FACILITY UNIT NAME:~ ~. PHONE *: RO~--~-3~q ' - PHONE ~: [OFFICIALo~i,y USE. CFIRS CODE I 2 3 4 '5 0 ' ? 8 9 1 0 TYPE MAX ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR C~MMON NAME CODE GUIDE NAME:' '', ' TITLE: _ ~ SIGNATURE: ~DATE: EMERGENCY CONTACT: ~..~ ~~/I TITLE: ~-~'~ PitONE ~ BUS HOURS: ~FTER BUS E~ERGE~C~ CO~ThCT: TITLE: ~0~ ~ BUS ~O~RS: PRInCIPaL BUSINESS ~CTIVIT~: ~FTER BUS ~RS: CONTAINER CODES TYPE CODES 01. Underground Tank P = Pure 02. Aboveground Tank 'M = Mixtures of pure 03. Fixed Pressurized Tank substances 04. Pot%able Pressurized Cylinders W = Wastes (Also add 05. Insulated Tank (Includes Cryogenics) appropriate waste 06. Drums or Barrels - Metallic code) 07. Drums or Barrels - Non-Metallic 08. Carboy(s) 09. Glass Container(s) Z~0. Plastic Container(s) 11. Box(es) UNIT CODES 12. Bag(s) : 13. Metal Containers (Not Drums) LBS = Pounds 14..In Machinery or processing equipment TON = Tons (2,000 lbs) 15.' Bin(s) GAL = Gallons 99. OTHER - Specify on separate sheet BBL ~ Barrels (42 gals) Ft3 = Cubic Feet ' CUR = Curies USE coDEs 01..Additive 23. Herbicide Z/ 02, Adhesive 24. Insecticide 03.,Aerosol 25. Instructional 04..Anesthetic 26. Lubricant 05.'Bactericide ~27'~. ~al Aid or Process 06.,.Blasting 28. Neutralizer ',,:*07.· Catalyst 29. Paintlng :08. Cleanlng $0. Pesticide ~'09.::~Coolant $1. Plating .,10. Cooling 32. Preservative 11. DriIltng 33. Refining ~i ";1,2. 'Drying 34. Sealer 13.'Emulsifier/Demulsifier 3§. Spraying 14 ..Etching 36. Sterilizer 15 Experimental 37. Storage 16. Fabrication 38. Stripper. 17. Fertilizer 39 Washing lg. Formulat!on 40 Waste 19.'Fuel 41 Water Treatment 20. Fungicide 42 Welding Soldering 21. :Grinding 43 Well Injection 22 .... Heating, 44 0il Treatment 99 OTHER-Specify on HAZARD CODES EXPL - ExPlosive ORMA - Anesthetic, Irritant CMLQ - COmbustible Liquid ORME - Hazardous Waste CMSL - Combustible Solid ORMS - Other regulated Material,B,C,and D CRMT - Corrosive Material PSNA - Poison A (Gas) FI, OS - Flammable Oas PSNB - Poison B'(Liquid or Solid) FLL0 - Flammable Liquid RADI - Radioactive FL$'L - Flammable Solid WATR ' Water Reactive ~ 'NFI,G -'Non-Flammable Oas ETIO - Etiolog!cal Agent OOPX - Organic Peroxide PYRO - Pyrophoric. Hypergolic or spontaneously,combustible CR~O Cryogenics - ~' ,.c'. ='~' APPLICATION - RESTRICTED MATERIALS PERMIT 'lk::: ;1~ ,L-:,-.,, -., O FOR POSSESSION oNLy~ FOR POSSESSION AND USE PERMIT NO.· ~<~' + -'~ J"~. "' (';;:' m':'l ~' PE~MITTEE ADDRESS CITY ZI~ PHONE '~ITYPE OF PERMIT EXPIRATIO~ ~ PRIVATE APPLICATO~ ~ STRUCTURAL PCO,.~i ~ AGRICULTURAL PCO ~ COMMERCIAL APPLICATOR NOTICE OF INTENT REQUIRED ~ MUST BE SUBMITTED AT LEAST ~HOURSPRIOR TO APPLICATION. METHOD: ~'~.~ ~ ~.~. ' A. PESTICIDES/PESTS ~ ' ,-.----, ., ~. ""~ v~ · 8. ~4. ...~....~ . ~> ..... 5. ~. ~T:~'~ ,>. ~/'x,." ~J"v' ,,v~.. J 1. 17. .,. ",,)-',-~...,:.-~.~?'~>,,:-- ,~..-'?'~ ,~. . .... B.. LOCATION~ s~c TWN R~G~ ~P .~O~OO,Ty ~/ PEST, C,O~S J PESTS ~ .J~*JM** RATE ~'~/ . '. ~'~A:.N~: ~'~'~ " ~. ~.,~ ~,, ~ .~ ' . . ~ . ~C~NAME.._ ... ~ ~: 'f"~ ADDRESS PHONE ~CO NAME )AbE~'ESS PHONE ...L~. ¥ ',.... ~.~,v~,~ .' C. J~STIFICATION FOR NON-AG USE: D. CONDITIONS: '-..~..~ '?~., >_. ~.,~,, .... ~ ~.,~..~ .... ~ · "" ......... ,.-.'-~'~'~-~-~ I understand that th~s permit does not relieve me from liability for any damage to persons or property caused by the use of these pesticides. I waive any *Formulation: L-Liquid B-Bait D-Dust claim of liability or damages against the county department of agriculture based on the issuance of this permit. I further understand that this permit may F-Fumigant G-Granules be revoked when pesticides are used in conflict with the manufacturer's'labeling or in violation of applicable laws, regulations and specific conditions WP-Wettable Powder O-Other of this permit. I authorize inspection at all reasonable times and whenever an emergency exists,by the Department of Food and Agriculture or theCounty Department of Agriculture of all areas treated or to be treated, storage facilities for pesticides or emptied.Fontainers and equipment used or to be used **Method: A-Air Gr-Ground in the treatment. "? ,'--'/ ~l"'~/ / !'~'~ -~'~-', ;~;' F-Fumigation O-Ot]~er': '~PP~CANT SIGNATURE ' . .... I'~ TITLE DATE i i i TED MATERIAL PERMIT IS HEREBY GRANTED FOR THE ABOVE MATERIALS. APPLICATION DENIED. ~,y ' ~" ~~_~- ...... ' "-~"~'~ DATE ~-1~ A2~o ~ 5~0 {i'.-. .... APPLICATION - RESTRICTED MATERIALS - SUPPLEMENT PERI, IT NO. MAP' ACRES/ j 'PESTS J F'.IM** (~RATE O'LUTION/ DATE/ ,LOCATION SEC TWN RNG ID COMMODITY UNIT~ ~ESTICIDES ' VOLUME APPL TIMtNG 9. 20 23. 24. I ' I I 32, 34, *Formulation: L-Liquid B-Bait D-Dust F-Fumigant APPLICANT SIGNATURE DATE ~) O-Granules WP-WettabJe Powder O-Other **Method: A-Air ' F-Fumigation Or-Ground O-Other , DAT~ . Permit No. (,~,--c~,, PERMIT CONDITIONS SUPPLEMENT Permittee Initials The following are specific CONDITIONS OF USE which apply to Restricted Materials applications in the listed locations: I, DO NOT APPLY RESTRIC~ ~RIA~ BY AIR WITHIN 1/4 MI~ OF A ~SIDE~IAL'.~ OR OCCUPI~ ~R ~ IN: Si te Sec. Twn. Rng,_ S~ te Sec~....Twn. Rng. ,. ,, 4. 8. II, ~ NOT ~PLY RESTRICT~ ~TERIALS BY AIR WITHIN ]/q HI~ OF A SCH~L IN-sESsION IN: si te Sec. Twn. Rng ~ Si re, Sec. Twn. Rng. 1. 5. 2. 6. 3. 7. 4. 8. · III, DO NOT ALLOW RESTRICTED MATERIALS ,TO'DRIFT ONTO OR INTO THE FOLLOWING SENSITIVE AREAS: Si te Sec. Twn. 'Rng. ~ ~e ~ec. [wn. Rng. 4. 10. ' 6. 12. Distribution: White - County; Yellow, Pink & Gold - Permittee Ag. Comm. 580 2610 136 (Rev. 5-83) RUBEN BARTELL FARMS GENERAL FARMING ROUTE 8, BOX 1 -'~' YEARS OF /'1~O r / F / C ~ ~'-[~//../,. ~- FOOD & CO~ON PRODUCTION